If you’ve ever suddenly experienced a relentless itch and strange discharge from your vagina, you probably know something’s up down there. And blame is typically first assigned to a yeast infection.
A yeast infection is a common-yet-uncomfortable overgrowth of the fungus Candida around the vulva or the area around the vaginal opening. Including the two aforementioned issues, the most common symptoms of a yeast infection are instances of “pain with urination and vaginal burning or soreness,” according to Megan Quimper, an OB-GYN at The Ohio State University Wexner Medical Center.
These days, you can buy at-home treatments for yeast infections over the counter at local drugstores ― which makes nixing those unfortunate symptoms seem a whole lot easier. But should you opt for these treatments instead of visiting your doctor?
It’s a complicated question, according to Lauren Streicher, a clinical professor of Obstetrics and Gynecology at the Northwestern University’s Feinberg School of Medicine and author of Sex Rx. Complicated enough that it should give you cause for pause before you start applying those over-the-counter creams. In fact, “the majority of the time people think they have a yeast infection, they don’t,” Streicher explained.
“The majority of the time people think they have a yeast infection, they don't.”
Research indicates as much: One 2002 study of women who self-diagnosed and tried to treat a yeast infection showed they reached the correct conclusion just 33 percent of the time, and another 2007 study found just 26 percent were right on self-diagnosis.
If you get the diagnosis of yeast infection correct, you can often clear up symptoms with an OTC treatment. But while most vaginal yeast infections are related to the Candida type of yeast, there are also other ones to contend with, Quimper said. As a result, the treatment may vary. And in that case, the drug store products may not do you any good.
The other problem? There are many potential vaginal issues that cause similar symptoms to yeast infections, including sexually transmitted infections and bacterial vaginosis (BV), which Streicher said typically occurs with a “change in vaginal pH.” She explained that something as simple as a heavy period, douching, or even sex can upset the balance of bacteria around the vagina, leading to the discharge and odor characteristic of BV.
If you suspect you might have a yeast infection, there’s a chance you’ll be OK taking matters into your own hands. If you have the two classic symptoms of the condition ― vaginal itching and discharge ― it’s “safe to try an OTC treatment with topical therapy, as long as you’re not allergic to such medications,” Quimper said. “But if you have a history of recurrent yeast infections or infections with [other yeast species], you should see your doctor for evaluation.”
Ultimately, though, it’s better for you in the long run to seek the advice of your physician. Streicher said the major risk of not visiting your doctor immediately is the loss of money on OTC products that don’t end up working and the longer duration of those less-than-thrilling symptoms. The benefit of going to your doctor is that they can probably identify the exact type of yeast causing your infection ASAP.
“We can diagnose in a number of ways but we’ll look under a microscope, which picks up most types of yeast,” Streicher said. “The results are almost instantaneous.” Streicher added she often calls patients as soon as they get home to let them know what they have and what the best treatments are.
The other upside of visiting your doctor is that you might be put on a treatment that’s easier to deal with. For example, your physician may prescribe you an oral antifungal medication called Diflucan, which a lot of people prefer over the messy OTC creams.
“From a compliance perspective, it’s probably better,” Streicher said. “Women can get irritated with the creams you get from the drugstore.” With OTC treatments, you typically insert an applicator into the vagina before bed, so the antifungal can work overnight.
The other benefit of visiting your doctor is ruling out other causes of your symptoms sooner.
“Untreated yeast infections can lead to long-term vaginal irritation and discomfort,” Quimper said, adding that it’s unlikely to be dangerous if left untreated for a while, but there are some risks if it ends up being an issue like an STI rather than a yeast infection. If you mistake symptoms related to another vaginal infection for a more innocuous yeast infection, and then delay treatment, it’s possible that some untreated conditions could leave you at risk for the “development of pelvic inflammatory disease and infertility,” Quimper said.
That’s why, whether you decide to check in with your doctor or grab an OTC treatment, it’s important to address any abnormal vaginal symptoms promptly. Don’t be afraid to pick up the phone and call him or her for advice. Sometimes an appointment isn’t even necessary.
“In a perfect world, everyone should come in if they’re unsure,” Streicher said. “In the real world, if you’re too busy to come in, you can call your doctor for an over-the-phone diagnosis ― with the caveat of, ‘it sounds like yeast, let me give you a treatment, and you come into the office if it doesn’t clear up.’”
Streicher said it is vital to see your doctor if the symptoms do not go away or they keep coming back. “You may have an unusual strain of yeast or another issue altogether,” she explained.
Whatever you decide to do, don’t live with uncomfortable vaginal symptoms for weeks or months.